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CMS RVU26D · Effective 2026-10-01

45560 Rectocele repair Medicare reimbursement rates in Idaho

Surgical repair of a rectocele is reported when the surgeon corrects weakened support between the rectum and vagina, rather than rectal prolapse. Compare 45560 office and facility rates across CMS payment localities in Idaho.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 45560 in Idaho?

Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$584.21

1 of 1 localities have a supported rate.

Payment area: Idaho

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 45560 in your payment locality →

Pelvic surgery

About 45560: Surgical rectocele repair

Surgical repair of a rectocele is reported when the surgeon corrects weakened support between the rectum and vagina, rather than rectal prolapse.

A rectocele occurs when the rectum bulges toward the posterior vaginal wall because the supporting tissue has weakened. This code describes a surgical repair directed at that defect. Gynecologic, urogynecologic, or colorectal surgeons may perform the operation for a patient with symptomatic pelvic organ prolapse in a surgical setting. The operative report should identify the rectocele and describe the repair performed; a diagnosis alone does not establish that this procedure was done.

Select this code for the rectocele repair documented, distinguishing it from vaginal posterior colporrhaphy and procedures for rectal prolapse. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 45560

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU11.21 · 59%
  • Practice expense (office) RVU5.84 · 31%
  • Malpractice RVU1.92 · 10%

863

Medicare services in 2024 · #3078 by national volume

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

45560 compared with similar codes

Office rates for Idaho, from the same CMS release.

57250

Posterior repair

Rectocele repair

No office rate

This code represents a separate rectocele repair; 57250 describes posterior colporrhaphy by the vaginal approach. Use the code matching the documented operative technique.

57260

Combined vaginal repair

Anterior and posterior walls

No office rate

57260 is for combined anterior and posterior vaginal wall repair. It is a different choice when both cystocele and rectocele defects are repaired.

45520

Rectal prolapse treatment

Local treatment, any method

$155.58

45520 concerns treatment of rectal prolapse, not a rectocele. Choose based on whether the operative target is rectal prolapse or the rectovaginal support defect.

Compare 45560 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

  • Idaho →

    Office / nonfacility

    Unavailable

    Facility

    $584.21

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 45560 in Idaho.

PPRRVU2026_Oct_nonQPP.csv

5,549

Code
45560
Physician work
11.21
Practice expense
5.84
Malpractice
1.92

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Facility calculation for 45560 in Idaho
ComponentRVULocality factorAdjusted
Physician work11.21× 1.00011.2100
Practice expense5.84× 0.9205.3728
Malpractice1.92× 0.4730.9082
Total RVUs17.4910
Conversion factor× 33.4009

Facility rate, Idaho$584.21

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work11.211
Practice expense5.840.92
Malpractice1.920.473

(11.21 × 1 + 5.84 × 0.92 + 1.92 × 0.473) × $33.4009 = $584.21

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

45560 billing questions

How does this differ from 57250?

Both relate to rectocele repair, but 57250 describes posterior colporrhaphy through a vaginal approach. Select the code that matches the operation documented.

Is modifier 50 appropriate for a bilateral repair?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be paid?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

What documentation supports reporting this code?

The operative report should identify the rectocele and describe the surgical repair. The diagnosis by itself does not show that the repair was performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 45560PPRRVU2026_Oct_nonQPP.csv, line 5,549 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet